Justin Boe (NPI# 1205925864, PAC ID# 5496754988) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1205925864 |
| PAC ID by PECOS | 5496754988 |
| Professional Enrollment ID | I20120718000755 |
| Full Name | Justin Boe |
| Organization Legal Name | GRADY MEMORIAL HOSPITAL |
| Address |
2220 W Iowa Ave Chickasha OK 73018-2738 |
| Phone Number | 4052242300 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF IOWA COLLEGE OF MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | INTERVENTIONAL RADIOLOGY, PEDIATRIC MEDICINE |
| Group Practice PAC ID | 0648175778 |
| Number of Group Practice Members | 40 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450587 | BROWNWOOD REGIONAL MEDICAL CENTER |
| 450340 | SAN ANGELO COMMUNITY MEDICAL CENTER |
| 450196 | PARIS REGIONAL MEDICAL CENTER |
| 450742 | BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE |
| 450747 | PALESTINE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2220 W Iowa Ave, Chickasha, OK 73018-2738 | 4052242300 | GRADY MEMORIAL HOSPITAL |
| 1408 Glenolde Pl, Edmond, OK 73003-2668 | 7134613573 | SINGLETON ASSOCIATES PA |
| 1408 Glenolde Pl, Edmond, OK 73003-2668 | 4242908004 | COASTAL RADIOLOGY ASSOCIATES PLLC |
| 1408 Glenolde Pl, Edmond, OK 73003-2668 | 2814664401 | EAGLE PARTNERS PLLC |
| 4816 Arbuckle Dr, Edmond, OK 73025-9616 | 3374394706 | RADIOLOGY ASSOCIATES OF SOUTHWEST LOUISIANA |
| 4816 Arbuckle Dr, Edmond, OK 73025-9616 | 6025216252 | SOUTHWEST DIAGNOSTIC IMAGING LTD |
| 1200 Everett Dr, Oklahoma City, OK 73104-5047 | 4052715211 | BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA - OU PHYSICIANS |
| 825 Ne 10th St, Oklahoma City, OK 73104-5417 | 4052714864 | BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA - OU PHYSICIANS |
| Organization Legal Name | GRADY MEMORIAL HOSPITAL |
| Physicians | 48 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shannon R Brady-bardsher | Nurse Practitioner | Grady Memorial Hospital | 113 S Rush Ave, Rush Springs, OK 73082-0277 |
| Abby M Housman | Family Medicine | Grady Memorial Hospital | 2100 W Iowa Ave, Chickasha, OK 73018-2736 |
| Miguel L Rodriguez | Internal Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Deacon Vice | Emergency Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Bryan Peck | Diagnostic Radiology | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Bruce L Storms | Emergency Medicine | Grady Memorial Hospital | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 |
| Kevin W Anderson | Family Medicine | Grady Memorial Hospital | 2100 W Iowa Ave, Five Oaks Medical Group, Chickasha, OK 73018-2736 |
| John Tien Doan | Nuclear Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Laura M Black-wicks | Family Medicine | Grady Memorial Hospital | 2100 W Iowa Ave, Chickasha, OK 73018-2736 |
| Mary Masterman | Family Medicine | Grady Memorial Hospital | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 |
| Street Address |
2220 W IOWA AVE |
| City | CHICKASHA |
| State | OK |
| Zip | 73018-2738 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Miguel L Rodriguez | Internal Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Deacon Vice | Emergency Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Bryan Peck | Diagnostic Radiology | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| John Tien Doan | Nuclear Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Bahiru B Mekete | Internal Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Dennis Reed Mcneely | General Surgery | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Brent L Wauters | Emergency Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Kale Zachary Melton | Emergency Medicine | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Nathan D Elfrink | Diagnostic Radiology | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| William T Stewart Jr. | Certified Registered Nurse Anesthetist (crna) | Grady Memorial Hospital | 2220 W Iowa Ave, Professional Medical Services, Chickasha, OK 73018-2738 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica Rhodes | Certified Clinical Nurse Specialist (cns) | Cancer Centers of Southwest Oklahoma, LLC | 210 S Mary Bailey, Chickasha, OK 73018-1832 |
| James F Monk | Chiropractic | 816 W Choctaw Ave, Chickasha, OK 73018-2310 | |
| Richard Varley | Optometry | 508 W Chickasha Ave, Chickasha, OK 73018-2412 | |
| James G Roberson | Optometry | John B Minnett Od Inc | 619 W Chickasha Ave, Chickasha, OK 73018-2413 |
| Christen R Clift | Optometry | John B Minnett Od Inc | 619 W Chickasha Ave, Chickasha, OK 73018-2413 |
| Robert A Fulton | Optometry | 402 W Chickasha Ave, Suite 100, Chickasha, OK 73018-2461 | |
| Alisa Valereyvna Tarasova | Nurse Practitioner | Physician Housecalls LLC | 304 S 29th St, Chickasha, OK 73018-2501 |
| Eunhye Steele | Nurse Practitioner | Physician Housecalls LLC | 304 S 29th St, Chickasha, OK 73018-2501 |
| Andrea Rae Roberts | Physician Assistant | Physician Housecalls LLC | 304 S 29th St, Chickasha, OK 73018-2501 |
| Ian Thompson | Family Medicine | Physician Housecalls LLC | 304 S 29th St, Chickasha, OK 73018-2501 |
| Find all physicians in zip 73018 | |||
| City | CHICKASHA |
| Zip Code | 73018 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | CHICKASHA + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Justin Boe.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.